非小细胞肺癌放疗前后VEGF水平与近期疗效间的关系
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摘要
目的探讨非小细胞肺癌患者放疗前后血清血管内皮生长因子(VEGF)水平变化以及与近期疗效之间的关系。方法选择2015年1月—2016年1月在本院接受放疗的非小细胞肺癌患者64例(肺癌组),采用酶联免疫吸附实验法(ELISA)检测患者放疗前及放疗后4周的血清VEGF水平,并与同期在本院体检的64名健康人(对照组)的血清VEGF水平进行比较。放疗结束4周后评价治疗效果,根据CT结果分为有效组(CR+PR)和无效组(SD+PD),分析血清VEGF水平与近期疗效的相关性。结果放疗结束后4周,CR患者7例,PR患者24例,SD患者25例,PD患者8例,治疗有效率为53.12%;非小细胞肺癌Ⅲa期患者血清VEGF水平明显低于Ⅲb期患者(P<0.05),与年龄、性别、病理类型无相关性(P>0.05);放疗后肺癌患者血清VEGF水平较放疗前明显降低(P<0.05),且放疗前后,肺癌组患者的血清VEGF水平均明显高于对照组(P<0.05);放疗前、放疗后无效组患者的血清VEGF水平均明显高于有效组(P<0.05);放疗后两组患者的血清VEGF水平均明显下降,但是无效组患者的血清VEGF水平仍处于高水平状态。结论放疗前血清VEGF水平较低的非小细胞肺癌患者相较于水平高患者的放疗效果好,观察VEGF动态水平变化有助于对患者病情及近期疗效的判断。
Objective To investigate the changes of serum vascular endothelial growth factor( VEGF)levels in patients with non-small cell lung cancer before and after radiotherapy and the its relationship with the short-term efficacy. Methods During January 2015 and January 2016,64 patients with non-small cell lung cancer in received radiotherapy in our hospital patients were selected as lung cancer group,and 64 cases of healthy people at the same period were selected as control group. Enzyme-linked immunosorbent assay( ELISA)was used to detect serum levels of VEGF before radiotherapy and four weeks after radiotherapy,and compared the serum level of VEGF. Four weeks after radiotherapy,the therapeutic effect was evaluated. According to the CT results,the patients were divided into effective group( CR + PR) and the invalid group( NC + PD),and the correlation between serum level of VEGF and short-term efficacy was analyzed. Results After 4 weeks of radiotherapy,7 patients with CR,24 patients with PR,25 SD patients,and 8 patients with PD,the effective rate was 53.12%. The serum levels of VEGF in patients with non-small cell lung cancer in Ⅲ a period significantly lower than the patients of stage Ⅲ b( P < 0. 05). The level of VEGF had no correlation with age,gender,and pathological type( P>0.05). The serum level of VEGF in patients with lung cancer was significantly reduced after radiotherapy( P<0.05),and the serum level of VEGF in patients with lung cancer was significantly higher than that in the control group before and after radiotherapy( P< 0.05).The serum VEGF levels in non-effective group were significantly higher than those in the effective group( P< 0.05) before and after radiotherapy. Serum VEGF levels were significantly decreased in both effective group and non-effective group,however,the levels of VEGF in the non-effective group still high.Conclusions The non-small cell lung cancer patients with lower level of serum VEGF before radiotherapy achieve better effect. The observation of the dynamic changes of VEGF is helpful to judge the patient's condition and the recent curative effect.
Objective To investigate the changes of serum vascular endothelial growth factor( VEGF)levels in patients with non-small cell lung cancer before and after radiotherapy and the its relationship with the short-term efficacy. Methods During January 2015 and January 2016,64 patients with non-small cell lung cancer in received radiotherapy in our hospital patients were selected as lung cancer group,and 64 cases of healthy people at the same period were selected as control group. Enzyme-linked immunosorbent assay( ELISA)was used to detect serum levels of VEGF before radiotherapy and four weeks after radiotherapy,and compared the serum level of VEGF. Four weeks after radiotherapy,the therapeutic effect was evaluated. According to the CT results,the patients were divided into effective group( CR + PR) and the invalid group( NC + PD),and the correlation between serum level of VEGF and short-term efficacy was analyzed. Results After 4 weeks of radiotherapy,7 patients with CR,24 patients with PR,25 SD patients,and 8 patients with PD,the effective rate was 53.12%. The serum levels of VEGF in patients with non-small cell lung cancer in Ⅲ a period significantly lower than the patients of stage Ⅲ b( P < 0. 05). The level of VEGF had no correlation with age,gender,and pathological type( P>0.05). The serum level of VEGF in patients with lung cancer was significantly reduced after radiotherapy( P<0.05),and the serum level of VEGF in patients with lung cancer was significantly higher than that in the control group before and after radiotherapy( P< 0.05).The serum VEGF levels in non-effective group were significantly higher than those in the effective group( P< 0.05) before and after radiotherapy. Serum VEGF levels were significantly decreased in both effective group and non-effective group,however,the levels of VEGF in the non-effective group still high.Conclusions The non-small cell lung cancer patients with lower level of serum VEGF before radiotherapy achieve better effect. The observation of the dynamic changes of VEGF is helpful to judge the patient's condition and the recent curative effect.
引文
[1]王静,贾敬好,杨海芳,等.非小细胞肺癌放疗前后血清TGF-β1水平测定的临床意义[J].河北医科大学学报,2017,38(6):654-658.
[2] Takai E,Tsukimoto M,Kojima S.TGF-beta1downregulates COX-2expression leading to decrease of PGE2 production in human lung cancer A549cells,which is involved in fibrotic response To TGFbetal[J].PLoS One,2013,8(10):e76346.
[3]李付海,白桦,李夏南,等.EGFR突变状态对Ⅲ期非鳞非小细胞肺癌患者放化疗近期疗效和长期生存的预测价值[J].中国肺癌杂志,2011,14(9):715-718.
[4]黄再捷.放疗前后非小细胞肺癌患者血清中血管内皮生长因子的表达水平及临床意义[J].实用医学杂志,2010,26(14):2503-2505.
[5]马瑾璐,金龙,韩苏夏,等.非小细胞肺癌患者放疗前后血清VEGF的水平变化及临床意义[J].西部医学,2015,27(6):822-827.
[6]顾涛,张彦秋,刘立杰,等.非小细胞肺癌患者化疗前后血清VEGF/血小板数和TGF-β1检测的临床意义[J].中国实验诊断学,2017,21(4):585-588.
[7]聂永莉,许涛,马红卫,等.三维适形放疗对老年中晚期肺癌患者的疗效及肿瘤标记物的影响[J].实用老年医学,2017,31(4):491-493.
[8] Flo kman J, Watson K, Ingber D, et al. Induction of angiogenesisduring the transition from hyperplasia to neoplasia[J].Nature,1989,339(6219):58-61.
[9]付宝红,关玲,付占昭,等.老年非小细胞肺癌患者血清VEGF、IL-8水平与放疗疗效的相关性[J].中国煤炭工业医学杂志,2016,19(7):1005-1006.
[10]周鹏,罗红兵,青浩渺,等.CT灌注参数及VEGF表达对非小细胞肺癌放疗后近期疗效评价及预测价值分析[J].肿瘤预防与治疗,2015,28(1):27-32.
[2] Takai E,Tsukimoto M,Kojima S.TGF-beta1downregulates COX-2expression leading to decrease of PGE2 production in human lung cancer A549cells,which is involved in fibrotic response To TGFbetal[J].PLoS One,2013,8(10):e76346.
[3]李付海,白桦,李夏南,等.EGFR突变状态对Ⅲ期非鳞非小细胞肺癌患者放化疗近期疗效和长期生存的预测价值[J].中国肺癌杂志,2011,14(9):715-718.
[4]黄再捷.放疗前后非小细胞肺癌患者血清中血管内皮生长因子的表达水平及临床意义[J].实用医学杂志,2010,26(14):2503-2505.
[5]马瑾璐,金龙,韩苏夏,等.非小细胞肺癌患者放疗前后血清VEGF的水平变化及临床意义[J].西部医学,2015,27(6):822-827.
[6]顾涛,张彦秋,刘立杰,等.非小细胞肺癌患者化疗前后血清VEGF/血小板数和TGF-β1检测的临床意义[J].中国实验诊断学,2017,21(4):585-588.
[7]聂永莉,许涛,马红卫,等.三维适形放疗对老年中晚期肺癌患者的疗效及肿瘤标记物的影响[J].实用老年医学,2017,31(4):491-493.
[8] Flo kman J, Watson K, Ingber D, et al. Induction of angiogenesisduring the transition from hyperplasia to neoplasia[J].Nature,1989,339(6219):58-61.
[9]付宝红,关玲,付占昭,等.老年非小细胞肺癌患者血清VEGF、IL-8水平与放疗疗效的相关性[J].中国煤炭工业医学杂志,2016,19(7):1005-1006.
[10]周鹏,罗红兵,青浩渺,等.CT灌注参数及VEGF表达对非小细胞肺癌放疗后近期疗效评价及预测价值分析[J].肿瘤预防与治疗,2015,28(1):27-32.